Final Exam Flashcards
1
Q
When drugs are absorbed in the GI where are they circulated first?
A
liver
2
Q
What organ/ system is in association with absorption in ADME?
A
Circulatory system / GI system
3
Q
What organ/ system is in association with distribution in ADME?
A
Circulatory system
4
Q
What organ/ system is in association with metabolism in ADME?
A
Liver
5
Q
What organ/ system is in association with excretion in ADME?
A
Kidneys
6
Q
what is a half life?
A
The time required for half of a given drug to me removed from the body
7
Q
What indicates a toxic therapeutic index?
A
The closer to 1 the greater the danger of toxicity
8
Q
What does a high therapeutic index (TI) mean?
A
safer
9
Q
What are the 6 rights of medication?
D, D, P, RO, T, RE
A
- drug
-dose
-patient
-route
-time - reason
10
Q
what are NSAIDS highly bound to?
A
protiens
11
Q
what are the C/I of taking asprin ?
A
- children w/ viral infection
12
Q
if you give a child asprin what disease are they at risk for?
A
Reye’s Syndrome
13
Q
what are the syptoms of chronic use of ASA (asprin)?
T, HL, CNS, GIU
A
tinnitus, hearing loss, CNS changes (breathing), GI upset
14
Q
when preforming an assesment before administering aspirin what should the nurse look for as an indication NOT to administer the medication to the patient?
VS, AT
A
vinegar smell
aspirin triad
15
Q
what is aspirin triad?
a, np, r
A
-asthma
- nasal polyps
- rhinitis
16
Q
what should the nuirse educate the patient on about Aspirin?
SAU, BW/OT, H
A
severe abdominal upset or pain
bruising w/o trauma
hematuria
17
Q
what is ketorolac (Toradol)?
A
analgesic equivalent to morphine but doesnt cause any chnages in conciousness
18
Q
what is ketoralac (Toradol) used to treat?
A
pain treatment for post op ortho trauma and surgery
19
Q
what are the adverse effects of Ketorolac (toradol)?
RI, GIP, N
A
renal impairment
GI pain
nausea
20
Q
what is the limit days for ketorolac (toradol)?
A
5 days due to risk of GI bleed
21
Q
what is tylenol used to treat?
A
nonopiod analegisc: mild to moderate pain
antipyretic
22
Q
what are the C/I of taking tylenol?
A, SLD, CA
A
- allergy
- severe liver disease
- chronic alcoholic
23
Q
what are the adverse effects of Tylenol?
NAHH
A
nausea
anemia
hepatotoxcity ( toxic liver)
24
Q
what is the antidote for a tylenol overdose?
A
acetylcysteine
25
when should acetylcystenine be started for a acetaminophen OD?
within 10 hours of OD
26
what is allopurinol (zyloprim) used to treat?
gout attacks
27
how does allopurinol (zyloprim) prevent gout attacks?
inhibits uric acid production
28
what are the C/I of allopurinol (zyloprim)?
| GI, D, R (SJS)
- GI upset
- drowsiness
- rash: stevens johnson syndrome
29
what should the patient be educated on before administration of allopurinol (zyloprim)?
| IFI, TWF, AD
- increase fluid intake
- take with food
- avoid driving
30
what is the diffrence between emperic and definitive therapy?
E: antibotic therapy prior to results of blood culture
D: a narrow spectrum antibotic that only kills specific bacteria
31
what are the most common adverse effects of antibitoics?
| GIU: N/V, D
GI upset
nausea, vomiting, diarrhea
32
what do all antibitocs block?
oral contraceptive pills
33
what kind of hypersenitive reaction should the nurse look for when a patient is taking antibiotics?
| EPI
- edema
- purtitus
- inspiration/ expiratory wheezing
34
what is the patho of docusate (colace)?
softens stool and makes the lining of intestine wall slick
35
what are the C/I of docusate (colace)?
| IO,UAP
intestinal obstruction
undiagnosed abdomial pain
36
what are the adverse affects of taking docusate (colace)?
| DAOV
decreased absorption of vitamins
37
what should the nurse educate the patient on when taking docusate (colace)?
increase fluid intake
38
what are the adverse effects of taking ondansetron (zofran)?
| H. D, PQTI
- headache
- dizziness
- prolonged QT interval
39
what should the nurse understand before administering ondansetron (zofran)?
| preg category
pregnancy category b; can be associated with cleft palate when taken during first trimester
40
what is metoclorpomaide used to treat?
| DGE
delayed gastric emptying
41
what is the C/I of taking metoclopramide (reglan)?
| CNS
- pt’s with a seizure disorder
- increased cns depression when taken with alcohol
42
what are the adverse affects of taking metoclopramide (reglan)?
| s, dm, f, ha
sedation
dry mouth
fatigue
headache
43
what should the nurse understand before administering metoclopramide (reglan)?
| timing
admin 30 minutes before meal and bed times
44
What is the patho behind antacids?
It neutralizes excess hydrochloric acid (HCl) in the stomach
45
What is the use of antacids?
Relives indigestion and heartburn
46
What are the C/I of taking antacids?
- antacids can block absorption of other meds
- DO NOT GIVE any magnesium products
- causes electrolyte disturbances
47
What are the adverse affects of taking antacids?
| Mg, Al, Ca
It varies on the type but
Mg- GI upset
Al- constipation
Ca- kidney stones and gas
48
What should the nurse assess in a patient taking antacids?
| HTN, MI
HTN
heart failure
49
What should the nurse educate the patient on when taking antacids?
- long term self medication w/ antacids mask manifestations of a serious underlying condition
- separate antacids by 2 hours from other meds
- pregnancy category A
50
when is a pt at risk for hypoglycemia?
when insulin is at its peak
51
what type of insulin is lispro ?
| 1-2 peak, 3-5
rapid acting
52
what is glargine insulin?
long acting insulin
53
what is the C/ I of taking levothyroxine (synthroid)?
| MI, AI, H
MI
adrenal insufficiency
hyperthyroidism
54
what are the adverse effects of taking levothyroxine (synthroid)?
| I, T, H , A, S, F
insomnia
tremors
headache
anxiety
sweating
fever
55
what is the adverse effects of overdosage of levothyroxine (synthroid)?
cardiac issues
56
when is thyroid medication supposed to be taken?
early in the morning 30 -60 minutes before food on an empty stomach
57
What do beta 1 blockers effect?
| DHR, DCC
Decreased HR
Decreased cardiac contractility
58
What do cardioselective beta blockers affect?
heart
59
What do beta 2 receptors effect?
| V, BC, DHR
vasodilation
bronchoconstriction
Delayed hypoglycemic recovery
60
What are beta blockers used to treat?
| POM/H, PMI
- prevention of migraine/ headaches
- post MI
61
What are the C/I of taking beta blockers?
| HB, B, PVD, DIG, DU, A
- heart block
- bradycardia
- PVD
- Digoxin
- diuretics
- asthma
62
what is the FDA BLACK BOX WARNING for Beta blockers?
| rebound
FDA black box: DO NOT ABRUPTLY STOP, taper off over a period of 1-2 weeks
abrupt withdrawal with result in MI, rebound HTN, and tachycardia
63
What are the adverse effects of taking beta blockers?
| 5 b's
bradycardia
breathing problems
blood sugar masking
bad HF
bad for falls
64
What are ACE inhibitors used to treat?
| HF, HTN, PMI
heart failure
HTN
post MI
65
What are the c/I of taking ACE inhibitors?
- do not give to pregnant women
- Black people do not respond well to ACE inhibitors
66
what is the FDA BBW when taking ACE Inhibitor?
fetal toxcity
67
What are the most common adverse effects of taking ACE inhibitors?
| AACE
A- void during pregnancy
A- ngioedema
C- ough
E- levated K+
68
What should the nurse educate the patient on when taking ACE inhibitors?
| DTN
DO NOT TAKE NSAIDS
69
What are the interactions when taking calcium channel blockers?
| A, HTN
angina
Hypotension
MI
70
What does CCB interact with?
| GFJ
grapefruit juice ( increased effect)
71
What is atrovastatin ( Lipitor) used to treat?
Reduce LDL levels and total cholesterol levels
72
What are the adverse effects of taking atorvastatin ( Lipitor)?
| DS, M+ JP, REDDISH BROWN
difficulty sleeping
myalgia and joint pain
rhabdomyolysis causing reddish brown urine
73
What are the contraindications of taking atrovastatin ( Lipitor) ?
| Px, LD
pregnancy category X
liver disease
74
What should the nurse educate the patient on when taking atrovastatin ( Lipitor)?
| Meal
take with evening meal or at bedtime
75
What is the antidote for warfarin?
Vitamin K
76
What labs need to be monitored for warfarin?
INR and PT
77
what labs need to be monitored with a pt taking heparin?
They need to monitor aPTT
78
What is the mechanism of action of Digoxin?
| IC, ISV
increased contractility
increase SV which decreases HR
79
what is digoxin used to treat?
heart failure
80
What are the C/I of taking digoxin?
| HB, VFIB
- heart block
-V-fib
81
What are the adverse effects of taking digoxin?
| H, F, B, NTI
headache, fatigue
bradycardia
narrow TI so they have a higher chance of toxicity
82
What kind of assessment should the nurse preform on a pt taking dig?
| CA, AP, EKMG,SDL, RF
- complete assessment ( confusion, constipation, decreased HR and BP, yellow and green halos)
- apical pulse for a full minute
- electrolytes K and Mg
- serum dig levels
- renal function
83
What should the nurse understand before administering Digoxin?
| HIHR, MRLD, AWM
- Hold if HR is below 60BPM or above 100 BPM
- may require loading dose
- administer w/ meals but not those high in fiber
84
What should the nurse educate the patient taking digoxin on?
check HR before taking
85
What are the early signs of dig toxicity?
| BAD VAN
B- bradycardia
A- anorexia
D- diarrhea
V- visual disturbances
A- abdominal cramping
N- nausea and vomiting
86
What is the antidote for dig toxicity?
| DF
Digoxin immune fab AKA: Digifab
87
What are the contraindicated for beta adrenergic agonist?
| Cardiac
uncontrolled HTN
cardiac dysrhythmias
high risk for stroke
88
What are the adverse effect of taking beta adrenergic agonists?
| 3 T’s
- tachycardia
- tremors
- trouble sleeping
89
What should the nurse educate the patient on when taking albuterol?
Shake it before you take it
90
What is salemterol (LABA) mainly used to treat?
COPD
91
What are the adverse effects of taking salmeterol (LABA)?
| HTN, NM/SP
HTN
neuromuscular and skeletal pain
92
What should the nurse educate the patient on when taking corticosteroids?
- rinse your mouth after
- take steroids last
93
What is diphenhydramine (Benadryl) used to treat?
| MS, POS, AR
motion sickness
promotion of sleep
allergic reaction
94
What is atropine (anticholinergic) used to treat?
| B, Death rattle, A
- bradycardia
- antidote anticholinesterase inhibitor toxicity
- dry up mucous membranes
95
What are the contraindications of taking atropine (anticholinergic)?
| CAG, GI/GUO, UC
closed angle glaucoma
GI or GU obstruction
severe ulcerative colitis
96
What are benzodiazepines used to treat?
| A, AW, I, MS
anxiety, alcohol withdrawal, insomnia, muscle spasms
97
What are the contraindications/ interactions of taking benzodiazepines?
| NAG, CNSD, GFJ
- narrow angle glaucoma
- dont mix w/ other CNS depressants and alcohol
- don’t drink grapefruit juice
98
What are the four different categories of CNS depressants?
| Benzo, H, Bar, MR
benzodiazepines
hypnotics
barbiturates
muscle relaxers
99
What is the FDA BBW for benzodiazepines?
| RFA, PD, DCW/BOO
- risk for abuse
- physical dependence
- dont combine w/ other benzo’s or opioids
100
What are the adverse effects of taking benzodiazepines?
| HYPO, C, SS, A, N/V, DM
Hypotension
confusion
slurred speech
ataxia
nausea
vomiting
dry mouth
101
What should the nurse understand before administering benzodiazepine?
| Paradoxical and rebound
- Paradoxical excitation causing hyperactivity and aggressive behavior may occur in all all ages
- rebound disinhibition may occur in older adults after tapering
- rebound insomnia may occur if abruptly stopped
102
What should the nurse educate the patient on before taking benzodiazepines?
| WO, TWF, CPS, DS/DD
- wean off to stop
- take with food to avoid GI upset
- change positions slowly to prevent falls
- do both skip doses or double dose
103
what is the antidote for benzodiazepines?
Flumazenil
104
What can flumazenil (antidote) cause?
abruptly withdrawal including seizures in long term user
105
what is dextroamphetamine sulfate used to treat?
| A, N
ADHD and narolepsy
106
what are the C/I of taking dextroamphetamine sulfate?
| aggrevates and do not
- aggrevates anxeity disorder, tourettes, HTN
- DO NOT admin to pt who has received MAOI therapy
107
what are the adverse effects of taking dextroamphetamine sulfate?
| CP, R, M, BV, I, T, GIU
cardiac problems
( tachycardia, HTN, angina, dysrhytmias)
restlessness
mania
blurred vision
insomnia
tremors
GI upset
( N/V, diarrhea, anorexia, weight loss )
108
what should the nurse understand before administering dextroamphetamine sulfate?
| DH, DNAL
drug holidays
do not administer later than noon
109
what should the nurse educate the patient on when taking dextroamphetamine sulfate?
| AC, DNTOTC, AE
- avoid caffeine
- DO NOT take any OTC cough or cold medication w/o first consulting the HCP
- administer early in the day
110
what are “triptans” sumatriptan used to treat?
actue migranes
111
what are the C/I of taking “triptans” sumatriptan?
| CD
cardiovascular disease
112
what are the adverse effects of taking “triptans” sumatriptan?
| N/V, CV, P, F
coronary vasoconstrict ( neck amd chest tightness)
paresthesia’s
flushing
113
what should the nurse educate the pt on when taking “triptans” sumatriptan?
| aura
take at the first sign of migraines
114
what are opiods used to treat?
- moderate to severe pain
- supression of the cough reflex
- treatment of chronic diarrhea
115
what are the C/I of taking opiods?
| A, EICP, SA, PI
- asthma/ respiratory insufficiency
- elevated ICP
- sleep apnea
- paralytic ileus
116
what is the FDA BBW for opiods?
| DNCWB
do not combine with benzodiazepines
117
what are the adverse effects of taking opiods?
| DR, S, N/V, C UR, I, PPP
- decreased respiratory
- sedation
- N/V
- constipation
- Urinary retention
- itching
- pinpoint pupils
118
what are the two reasons a nurse should hold a dose of opiods?
hold dose if:
RR is less than 10
pt is sedated and not arousable even w/ stimulation
119
what should the nurse educate a patient on when taking opiods?
| IIO: F F SS
increase intake of:
fiber
fluids
stool softners
120
what is prednisone used to treat?
| steriod
- inflammation
- exacerbations of chronic respiratory illnesses
121
what are the adverse effects of taking corticosteriods?
- hyperglycemia
- HTN
- poor wound healing
- weight gain
- peptic ulcer
- emotional instability
122
what is lasix used to treat?
| HTN, ME
- HTN
- manage edema associated w/ HF, hepatic or renal diseases
123
what are the adverse effects of taking Lasix?
| T, GIU, HYPO, HG/U
- tinnitus
- GI upset
- hypokalcemia
- hyper glycemia/ uricemia
124
what is spironolactone used to treat?
| HTN, RKL, HF
- HTN
- reversing K+ loss
- HF
125
what are the adverse effects of taking spironalactone?
| GIU, DIZZ, H, UF
- GI upset
- dizziness
- headache
- urinary frequency
126
what are the C/I of taking spironalactone?
| L, A, N
- lithium
- ACE inhibitors
- NSAIDS
127
what is the outcome of infusing famotidine too quickly IV?
hypotension
128
what are the common adverse effects of taking famotidine?
| H, D
headache and diarrhea
129
what s/s should the nurse report to the HCP for a pt taking famotidine?
| BTS, IR/LL, B, ST, R
- black tarry stools
- irregular renal and liver labs
- bruising
- sore thorat
- rash
130
what should the nurse educate a pt taking famotidine on?
- smoking decreases effective
- take 1 to 2 hours before antacids
131
what are the C/I of taking SSRI’s?
| M, L, METO, B, W, SJW
highly protien bound
MAOIs
lithium
metoclopramide
benzo
warfarin
st john’s wort
132
What are the adverse effects of taking SSRI’s?
3D, A, SS
3 d’s
asthenia
serotnin syndrome
133
what is phenytoin (dilantin) used to treat?
patrial seizures
134
what are the C/I of taking phenytoin (dilantin)?
| B,HPBD, MDI
bradycardia
highly protein bound drug
many drug interactions
135
what should the nurse understand before administering phenytoin (dilantin)?
| measles
- if the pt has a measles type of rash contact HCP and hold dose
- review baseline eyes, neuromuscular, CBC, and liver function
136
what is the only solution that phenytoin (dilantin) can be infused w?
normal saline
137
what is carbidopa- levodopa used to treat?
parkinson's disease
138
what are the C/I of taking Carbidopa- levidopa?
| NAG, MM, NMAOI B, AP
- narrow angle glaucoma
- activates malignant melanoma
- nonselective MAOI
- benzo's
- antipyschotics
